Monitor Aneurysm Closely

GOOD HEALTH

Dear Dr. Donohue: I am a 68-year-old man with a stomach aneurysm. My doctor tells me that surgery will be needed when it gets to "four centimeters."I fear that is too long to wait. - H.R.

Dear H.R.: An aneurysm is a bubblelike weakening of a section of the aorta, often as that vessel traverses the abdomen. The danger, of course, is of a bursting of the bulge and hemorrhaging that would ensue. A rule of thumb is that an aneurysm smaller than 4 centimeters wide - slightly more than an inch and a half - can safely be watched. Much depends on the patient, the present aneurysm size and its history of growth. The practice is to remeasure an aneurysm with ultrasound every three to six months.

Surgery carries with it the risk of any such procedure. Many aneurysms never reach the danger stage. But any sudden increase in blood pressure can change the prognosis markedly and hasten the day of surgery, even with an aneurysm of otherwise safe size.

Dear Dr. Donohue: I have been diagnosed with Epstein-Barr virus. Can you tell me about that virus and how it is cured? - R.C.

Dear R.C.: About 90 percent of us have been exposed to the EB virus, which causes mononucleosis. Many were never aware they had mono, so minor were the symptoms.

A mono infection usually produces two or three weeks of fatigue and other symptoms, such as fever, sore throat and lymph node enlargement. Most patients recover with rest and avoidance of strenuous exercise. There is no drug to fight the virus.

Dear Dr. Donohue: Can you tell me anything about piriformis syndrome? All I know is that it involves a back muscle and is rare. - Mrs. B.

Dear Mrs. B.: The piriformis muscle lies deep in the buttock. Its claim to fame arises from its unfortunate position in the lower back, directly over the important sciatic nerve. When the piriformis impinges on that nerve, radiating pain - sciatica - can occur at any point along the nerve.

Heat application and exercise to stretch and relax the muscle help. Many times, the assistance of a physical medicine specialist is needed.